Measuring organizational context in Australian emergency departments and its impact on stroke care and patient outcomes

Verena Schadewaldt; Benjamin McElduff; Catherine D'Este; Elizabeth McInnes; Simeon Dale; Oyebola Fasugba; Dominique A. Cadilhac; Julie Considine; Jeremy M. Grimshaw; N. Wah Cheung; Chris Levi; Richard Gerraty; Mark Fitzgerald; Sandy Middleton

doi:10.1016/j.outlook.2020.08.009

Measuring organizational context in Australian emergency departments and its impact on stroke care and patient outcomes

Verena Schadewaldt^*, Benjamin McElduff, Catherine D'Este, Elizabeth McInnes, Simeon Dale, Oyebola Fasugba, Dominique A. Cadilhac, Julie Considine, Jeremy M. Grimshaw, N. Wah Cheung, Chris Levi, Richard Gerraty, Mark Fitzgerald, Sandy Middleton

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Background: Emergency departments (ED) are challenging environments but critical for early management of patients with stroke. Purpose: To identify how context affects the provision of stroke care in 26 Australian EDs. Method: Nurses perceptions of ED context was assessed with the Alberta Context Tool. Medical records were audited for quality of stroke care and patient outcomes. Findings: Collectively, emergency nurses (n = 558) rated context positively with several nurse and hospital characteristics impacting these ratings. Despite these positive ratings, regression analysis showed no significant differences in the quality of stroke care (n = 1591 patients) and death or dependency (n = 1165 patients) for patients in EDs with high or low rated context. Discussion: Future assessments of ED context may need to examine contextual factors beyond the scope of the Alberta Context Tool which may play an important role for the understanding of stroke care and patient outcomes in EDs.

Original language	English
Pages (from-to)	103-115
Number of pages	13
Journal	Nursing Outlook
Volume	69
Issue number	1
DOIs	https://doi.org/10.1016/j.outlook.2020.08.009
Publication status	Published - 1 Jan 2021

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Schadewaldt, V., McElduff, B., D'Este, C., McInnes, E., Dale, S., Fasugba, O., Cadilhac, D. A., Considine, J., Grimshaw, J. M., Cheung, N. W., Levi, C., Gerraty, R., Fitzgerald, M., & Middleton, S. (2021). Measuring organizational context in Australian emergency departments and its impact on stroke care and patient outcomes. Nursing Outlook, 69(1), 103-115. https://doi.org/10.1016/j.outlook.2020.08.009

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title = "Measuring organizational context in Australian emergency departments and its impact on stroke care and patient outcomes",

abstract = "Background: Emergency departments (ED) are challenging environments but critical for early management of patients with stroke. Purpose: To identify how context affects the provision of stroke care in 26 Australian EDs. Method: Nurses perceptions of ED context was assessed with the Alberta Context Tool. Medical records were audited for quality of stroke care and patient outcomes. Findings: Collectively, emergency nurses (n = 558) rated context positively with several nurse and hospital characteristics impacting these ratings. Despite these positive ratings, regression analysis showed no significant differences in the quality of stroke care (n = 1591 patients) and death or dependency (n = 1165 patients) for patients in EDs with high or low rated context. Discussion: Future assessments of ED context may need to examine contextual factors beyond the scope of the Alberta Context Tool which may play an important role for the understanding of stroke care and patient outcomes in EDs.",

keywords = "Alberta Context Tool, Emergency care, Guideline implementation, Knowledge transfer, Organizational context, Research utilization",

author = "Verena Schadewaldt and Benjamin McElduff and Catherine D'Este and Elizabeth McInnes and Simeon Dale and Oyebola Fasugba and Cadilhac, {Dominique A.} and Julie Considine and Grimshaw, {Jeremy M.} and Cheung, {N. Wah} and Chris Levi and Richard Gerraty and Mark Fitzgerald and Sandy Middleton",

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Schadewaldt, V, McElduff, B, D'Este, C, McInnes, E, Dale, S, Fasugba, O, Cadilhac, DA, Considine, J, Grimshaw, JM, Cheung, NW, Levi, C, Gerraty, R, Fitzgerald, M & Middleton, S 2021, 'Measuring organizational context in Australian emergency departments and its impact on stroke care and patient outcomes', Nursing Outlook, vol. 69, no. 1, pp. 103-115. https://doi.org/10.1016/j.outlook.2020.08.009

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AU - McElduff, Benjamin

AU - D'Este, Catherine

AU - McInnes, Elizabeth

AU - Dale, Simeon

AU - Fasugba, Oyebola

AU - Cadilhac, Dominique A.

AU - Considine, Julie

AU - Grimshaw, Jeremy M.

AU - Cheung, N. Wah

AU - Levi, Chris

AU - Gerraty, Richard

AU - Fitzgerald, Mark

AU - Middleton, Sandy

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N2 - Background: Emergency departments (ED) are challenging environments but critical for early management of patients with stroke. Purpose: To identify how context affects the provision of stroke care in 26 Australian EDs. Method: Nurses perceptions of ED context was assessed with the Alberta Context Tool. Medical records were audited for quality of stroke care and patient outcomes. Findings: Collectively, emergency nurses (n = 558) rated context positively with several nurse and hospital characteristics impacting these ratings. Despite these positive ratings, regression analysis showed no significant differences in the quality of stroke care (n = 1591 patients) and death or dependency (n = 1165 patients) for patients in EDs with high or low rated context. Discussion: Future assessments of ED context may need to examine contextual factors beyond the scope of the Alberta Context Tool which may play an important role for the understanding of stroke care and patient outcomes in EDs.

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Measuring organizational context in Australian emergency departments and its impact on stroke care and patient outcomes

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